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Melasma

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Melasma is a chronic and relapsing disease despite adequate treatment. The more prominent the pigmentation, and the more extensive the disease, the less effective the treatment response and the more common the relapses, principally after sun exposure or skin injury. Melasma tends to fade spontaneously after menopause and with aging, probably due to the decrease of hormones and gradual loss of melanocyte number and function in the epidermis.

Melasma is a chronic and acquired localized hyper melanosis. It affects mainly women of intermediate phototypes during fertile age. Sun exposure is the main risk factor for melasma, exerting role both in it appears as in worsening and maintenance. Regular application of broad-spectrum and physical sunscreen, as well as avoidance of ultraviolet and visible light, is important for preventing a recurrence.

The depth of Melasma (epidermal or dermal) decides the modality of treatment. At our clinic, topical treatment with lightening agents is the first line of therapy. Lasers non- ablative, fractional re-surfacing decreases the number of Melanocytes in the upper layer. Q- switched lasers also remain the mainstay of the treatment. In our clinic, micro-needling with deep tissue perfusion is done at regular intervals which helps in lightening of the skin, better texture, and tightening of the skin. The meso solutions could range from Kojic acid, Vitamin C, Azelaic acid and various other cocktail combinations as required are done.